Elder Law

Five Members of Long-Term Care Commission Issue Separate Report

Published on: September 25, 2013 | by Ettinger Law Firm

Yesterday we discussed the release of the federal Long-Term Care Commission’s final report. As mentioned, the major glaring issue with the report was its relative silence on financing solutions for this care. The Commission was made up of individuals with varying interests–from owners to residents–who have very different incentives. Issues regarding payment for long-term care services, particular Medicaid, is always a contentious topic. In that vein, it is perhaps not surprising that the report did not issue conclusive recommendations on that front.

Yet, that did not stop a subset of the Commission from issuing their own dissent which directly addressed the financing issue. A full version of that 17-page alternative report can be read online here.

Alternative Report

Final Report Issued by Federal Long-Term Care Commission

Published on: September 24, 2013 | by Ettinger Law Firm

You may remember that on New Year’s Day of this year, a large piece of legislation was passed by Congress and signed by President Obama. The bill was the one that (temporarily) avoided the fiscal cliff. It was the measure that seemed to permanently set the estate tax rates among other things.

At the same time, the legislation also called for the creation of a Long-Term Care Commission. Comprised of 15 members, selected by both Republican and Democratic leaders, the group was given six months to hold hearings, debate, discuss, and create a report on various issues regarding long-term care nationwide. More specifically, the entity’s specific charge was to “develop recommendations for the establishment, implementation, and financing of a comprehensive, coordinated, and high-quality system that ensures the availability of long-term services and supports for individuals who depend on this system to live full and healthy lives.”

The Recommendations

Home Health Care Workers to Receive Additional Worker Protections

Published on: September 17, 2013 | by Ettinger Law Firm

A growing number of New York seniors in need of caregiving support are opting to stay in their homes, instead of moving into nursing facilities. This is partially a result of Medicaid programs changing to accommodate more at-home caregiving, often saving money and better meeting elderly preferences at the same time.

As a result, more and more attention is being paid to home caregivers. In particular, some are voicing concern about potential negligent care. Obviously, caregivers can fall far short of standards no matter what the setting, from nursing homes to traveling support. One particular concern with home caregiving aides is that, unknown to many, they actually fall under an exempted category in the Fair Labor Standards Act–the federal law which includes issues like the minimum wage, overtime pay, and more.

At least that was the case. According to new rules released today by the U.S. Labor Department, the specific definition of the “companionship exemption” under which these caregivers previously fell will be narrowed. Beginning in 2015, home caregivers will no longer be exempt, leading to significant changes in their employment status and, some hope, the quality of their work.

Federal Long-Term Care Commission Set to Issue Report

Published on: September 11, 2013 | by Ettinger Law Firm

Advocating for better long-term care is not just a concern of NY elder law attorneys. Policymakers at all levels and of all political persuasions are also keenly aware of the impact that the growing need for long-term care will have on communities nationwide.

There are few challenges more acute than figuring out how to ensure adequate senior care for all community members. As most know, we are on the cusp of a “gray wave” with demographics changes requiring an increased commitment to skilled care and assistance for seniors. The need extends to all facets of elder care, from ensuring there are enough physical spaces for those in need to coming up with ways to pay for the care.

Federal LTC Commission

Two More NY Nursing Homes Fined for Poor Care

Published on: September 6, 2013 | by Ettinger Law Firm

Late last month we shared information on New York’s performance in a national Nursing Home Report Card. A non-profit organization compiled the list using a mountain of government data related to staffing ratios, inspection results, and more. Sadly, New York did not come out of the examination looking that great. In fact, the overall state nursing home care was given a grade of F and listed as one of the worst places for long-term care in the country.

Importantly, this condemnation of the state’s general care does not mean that every facility in New York is substandard. There are many very high quality facilities that work diligently to meet the needs of all New York seniors who need assistance on a daily basis.

However, the report is a reminder that there are vast differences in quality between homes. Simply picking any facility will not due. Those who want to guarantee quality support for elder loved ones need to take time to investigate options and make educated choices. Finances often play a role in available options, and so families are encouraged to explore long-term care insurance and similar strategies to ensure resources will be available for this care down the road.

Unauthorized Charges: Financial Exploitation at the Dentist’s Office

Published on: September 4, 2013 | by Ettinger Law Firm

Advice is often given about checking a senior relative’s bank statements frequently to identify potential theft. Large cash withdrawals, donations to strange charities, and similar red flags should be pursued.

But sometimes elder financial exploitation is so bold, that victims–or their relatives–may not realize that they were mistreated.

For example, it is easy to overlook a large payment if it seems to be made for a reputable reason. Doctor’s payments may be quite large, but when skimming bank records, that payment may not immediately jump out as fraudulent. This creates an opening for exploitation.

Is There a New Way to Test for Dementia?

Published on: August 22, 2013 | by Ettinger Law Firm

It is a nightmare for many families. A senior shows signs of cognitive mental challenges–becomes forgetful and eventually is unable to live on their own. An adult child take control of the senior’s affairs in order to pay for bills and arrange for long-term care. But when the family member checks banks accounts they discover that the senior’s nest egg has been demolished. Tens of thousands of dollars have been funnelled out to strangers. The senior was the victim of financial exploitation, and now there is little money to pay for the long-term care that they need.

Believe it or not, this scenario occurs frequently. Dementia and Alzheimer’s are not rare diseases; they strike large portions of the population. Yet, because the signs build up only slowly, many family members do not realize the scope of their parent’s mental decline until far too late–after they hurt themselves in an accident or are financially decimated in a scam.

Because of the risks, elder law attorneys frequently remind residents to be proactive–checking up on loved ones frequently and putting legal documents in place to identify problems early on.

New York Nursing Homes & Poor Dental Care

Published on: August 5, 2013 | by Ettinger Law Firm

Most horror stories about poor nursing home care include tales of grotesque “bed sores,” broken bones gone undiagnosed, and similar cases of obvious caregiving lapses. But the best way to measure the quality of long-term care facilities may not be to see how many of these “big” mistakes are made. Instead, it might be more appropriate to look into resident’s mouths.

As a New York Times article discussed last week, there is a chronic problem of poor (and virtually non-existent) dental care provided at far too many nursing homes. A facility’s attention to dental care may be a key indicator of their overall commitment to proper support.

For one thing, many seniors do not have dental insurance. Medicare usually does not cover basic dental care. Medicaid might, but many have reported problems finding local dentists who accept Medicaid coverage. Without private insurance, many seniors simply go without regular cleanings and preventative care. Following a medical setback, dementia, or other challenge, many of these seniors land in nursing homes already in poor dental health.

NPR Story: Time to “Abolish” the Nursing Home

Published on: August 2, 2013 | by Ettinger Law Firm

It is no secret that the country is aging. More Americans are retiring and drifting into their golden years now then ever before. What’s more is that there is not a similarly-sized generation, meaning the percentage of elderly individuals is rising sharply.

All of this is leading many to evaluate the current state of elder care. As the population ages we will undoubtedly need more and more resources to provide the care that often comes with old age. For many, this is the first time that they have seriously considered the senior caregiving system in the United States–and many do not like what they see.

In fact, calls to create alternatives to the traditional nursing home system are louder now than they have ever been. For those who have sharp criticisms of the care provided to residents in these skilled nursing facilities, the idea of tens of millions more elderly loved ones being pushed into these facilities is frightening. As elder law attorneys often explain, the nursing home is usually the “last resort” for good reason.

Reverse Mortgage Case: Daughter Fights After Mother’s Passing

Published on: July 24, 2013 | by Ettinger Law Firm

Some adult children are forced to engage is prolonged legal battles after their parents passing over “reverse mortgages.” These mortgages are loans available to older homeowners. Essentially it allow the owners to withdraw money on their home in a lump sum or in monthly installments. For seniors who need immediate access to funds for emergency expenses, home care, or the like, the loan is tempting.

However, there are countless horror stories about unconscionable terms placed on the homeowner. Because the owners are usually seniors, there are many examples of elderly individuals who agree to the mortgage without truly appreciated what they are getting into. It is often up to adult children to work through the mess and fight for fairness after the fact.

For example, the Herald shared the on-going fight of one New York woman after her mother agreed to a downright “crazy” mortgage. As the story notes, the reverse mortgage in question had a base interest rate of 9.95%. On top of that the lender received a 50% share of any increase in the value of the home plus a 2% “maturity fee.” Even more there was a mandatory $33,000 annuity that needed be purchased by the homeowner with compounding interest on the balance. In other words, these are terms that most would be strongly advised against taking.